Lack of coverage sustained

Insurance coverage disputes often hinge on fundamental questions: was there actually a policy in effect at the time of an incident? In no-fault insurance cases, establishing the existence or absence of coverage is crucial for determining liability and benefits. When insurance companies claim no coverage existed, they must provide compelling evidence to support their position.

The Appellate Term’s decision in EMC Health Products v. Allstate Insurance Company demonstrates how courts evaluate evidence of non-coverage. This case illustrates the evidentiary standards insurers must meet when asserting that no policy covered a particular vehicle on the date of an accident. Understanding these standards is essential for both insurers defending against claims and plaintiffs pursuing New York No-Fault Insurance Law benefits.

Jason Tenenbaum’s Analysis:

EMC Health Prods., Inc. v Allstate Ins. Co., 2016 NY Slip Op 50314(U)(App. Term 2d Dept. 2016)

“In support of its cross motion and in opposition to plaintiff’s motion, defendant submitted an affidavit by its employee, who described the details of a record search which she had performed and stated that her search had revealed that there was no Allstate Insurance Company policy covering the vehicle in question on the date of the accident. We find that defendant’s affidavit was sufficient to demonstrate, prima facie, that plaintiff’s claim did not arise out of a covered incident”

The affidavit herein is valid to demonstrate that there was no coverage.

Key Takeaway

This decision establishes that a properly detailed employee affidavit describing systematic record searches can successfully demonstrate the absence of insurance coverage. The court found Allstate’s evidence sufficient to establish prima facie that no policy existed, shifting the burden back to the plaintiff to prove otherwise. This precedent is significant for coverage disputes where insurers must substantiate their defenses with thorough documentation.